Non-Birth Mothers Certified as Breastfeeding Women

The purpose of this policy memorandum is to clarify that women who breastfeed infants that they did not give birth to ("nonbirth mothers"), may be certified to participate in the WIC program as breastfeeding women at state option.

WIC regulations define breastfeeding women in Section 246.2 as "women up to one year postpartum who are breastfeeding their infants." Although this reference clearly indicates a biological maternal relationship, it was not the intent of regulations necessarily to exclude women who are breastfeeding infants to whom they did not give birth from being certified as WIC breastfeeding women. The Food and Consumer Service (FCS) would be in favor of a broader interpretation of the WIC regulations to achieve the breastfeeding and nutritional goals of the WIC program. However, it is a WIC state agency's decision whether to implement this policy.

Nutritional and medical research has shown that there is no better food than breast milk, a major source of nutrition for a baby's first year of life. Human milk, even if it is not from the natural mother, is generally recognized as the optimum source of nutrition for young infants , as it provides the ideal balance of nutrients, enzymes, immunoglobulins, anti- inflammatory substances, hormones, and growth factors.

Therefore, we do not intend to preclude the WIC certification of an otherwise eligible non-birth mother as a breastfeeding woman, if she is providing her breast milk for the nourishment of a WIC infant. some examples of a non- birth mother would include: a wet nurse; an adoptive mother; and a foster mother. However, this does not include women who donate breastmilk to a milk bank.

As with any breastfeeding woman, the breastfeeding non-birth mother must meet the eligibility requirements of residency, income, and nutritional risk. She may have her own independent nutritional risk, or be at nutritional risk because the infant she is breastfeeding is determined to be nutritionally at risk. If a non-birth mother has a nutrition risk condition that contraindicates her breastfeeding an infant (i.e . , substance abuse, HIV Infected), the guidance and education provided to her should be the same as that provided to a birth mother. A woman's health status could determine whether her breastmilk is the healthiest source of ·nourishment. for an infant. In this instance, however, a state agency is not obligated to certify a woman as breastfeeding.

If a state agency chooses to exercise the non-birth mot her option, they should establish written policies and procedures for certification. The state agency is reminded that a postpartum birth mother who meets eligibility criteria is eligible to receive postpartum benefits even if her infant is being breastfed by a certified non- birth mother. Under this scenario, only one woman can be classified in a breastfeeding status. The other woman must be classified in a non-breastfeeding postpartum status.

In determining income eligibility, the breastfed WIC infant does not necessarily have to reside with the non-birth breastfeeding mother. The household size should be determined by either the birth mother or non-birth mother claiming the infant in that household. The breastfed infant cannot be included in the family size of both the birth mother and nonbirth mother.

For purposes of determining the appropriate allowable timeframe for duration of certification as a breastfeeding non-birth mother, the age of the infant should be the determinant. As with natural birth mothers, a non-birth mother's status as a breastfeeding woman ends when she stops nursing the infant .at least once per day or at the infant's first birthday, which ever occurs first.

STANLEY C. GARNETT
Director
Supplemental Food Programs Division